OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CMS-10169)

OMB 0938-1016 · HHS/CMS.

OMB 0938-1016

CMS is seeking approval to reinstate the Information Collection Request (ICR) and to update our burden estimates to Forms A and B in preparation for the next round. CMS will publish a slightly modified version of Form A so that bidders will be better able to identify and understand the new requirement related to bid surety bonds (Section 1847(a)(1)(G) of the Act, added by section 522(a) of the Medicare Access and CHIP Reauthorization Act of 2015 (Pub. L. 114-10) (MACRA). We have made changes to Form B to remove the expansion plan section and to include the bidding methodology proposed in CMS-1691-P (83 FR 34304).

The latest form for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CMS-10169) expires 2029-10-31 and is listed under ICR 202512-0938-005.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form Form A Business OrganizationForm and Instruction
Form Form A Form A: Application for DMEPOS Competitve Bidding ProgramForm and Instruction
Form Form B Bid SheetForm and Instruction
Form Form B Manufacturer, Model Name, and NumberForm and Instruction
Form Form B ManufacturerForm and Instruction
Form Form B Create BidForm and Instruction
Form Form B CertificationForm and Instruction
Form CMS-10169 Form B _ Bidding FormForm and Instruction
Form Form B ManufacturerForm and Instruction
CMS-10169 - Supporting_Statement_Part_A to OSORA 06.04.26 (2026 version 12) CLEAN final.docxSupporting Statement A
Form A: Application for DMEPOS Competitve Bidding Program Form and Instruction
Form A: Application for DMEPOS Competitve Bidding Program Form and Instruction
Form A: Application for DMEPOS Competitve Bidding Program Form and Instruction
Form A: Application for DMEPOS Competitve Bidding Program Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction
Bidding Form (Form B) Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202512-0938-005 Reinstatement with change of a previously approved collection 2026-06-04
202507-0938-015 Reinstatement with change of a previously approved collection 2025-07-14
201812-0938-004 Reinstatement with change of a previously approved collection 2018-12-06 Approved without change
201807-0938-009 Reinstatement with change of a previously approved collection 2018-07-26 Comment filed on proposed rule
201703-0938-014 Revision of a currently approved collection 2017-03-23 Withdrawn and continue
201701-0938-004 Revision of a currently approved collection 2017-02-08 Improperly submitted and continue
201508-0938-005 No material or nonsubstantive change to a currently approved collection 2015-08-05 Approved without change
201411-0938-001 No material or nonsubstantive change to a currently approved collection 2014-11-03 Approved without change
201407-0938-008 Revision of a currently approved collection 2014-07-08 Approved without change
201305-0938-005 Revision of a currently approved collection 2013-05-10 Approved without change
201207-0938-007 Revision of a currently approved collection 2012-07-31 Approved without change
201111-0938-001 No material or nonsubstantive change to a currently approved collection 2011-11-02 Approved without change
201110-0938-009 No material or nonsubstantive change to a currently approved collection 2011-10-24 Withdrawn and continue
201006-0938-016 Revision of a currently approved collection 2010-06-30 Approved without change
201006-0938-010 No material or nonsubstantive change to a currently approved collection 2010-06-23 Preapproved
200906-0938-011 Revision of a currently approved collection 2009-06-22 Approved without change
200704-0938-009 No material or nonsubstantive change to a currently approved collection 2007-04-25 Approved without change
200701-0938-012 New collection (Request for a new OMB Control Number) 2007-01-12 Approved with change

OMB Details

Bidding Form (Form B)

Federal Enterprise Architecture: Health - Health Care Services

Information collection instruments
FormNameElectronic accessType
Form CMS-10169Form B _ Bidding FormFillable Fileable SignableForm and instruction
Form Form BBid SheetFillable FileableForm and instruction
Form Form BManufacturerFillable FileableForm and instruction
Form Form BCreate BidFillable FileableForm and instruction
Form Form BCertificationFillable FileableForm and instruction
Form Form BManufacturer, Model Name, and NumberFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.